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Published on: March 26, 2018
Acute Type A aortic dissection surgical repair in Octogenarians: A meta-analysis
Mohammed Tarek Hasan1, Hazem Salah Rezq1, Othman Saleh2
1Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
NPJ Cardiovascular Health
|March 3, 2026
Summary
Surgical repair for Type A aortic dissection in octogenarians shows lower re-exploration and stroke rates compared to medical treatment. However, this elderly group faces increased respiratory complications post-surgery.
Area of Science:
- Cardiovascular Surgery
- Geriatric Medicine
- Thoracic Surgery
Background:
- Aortic dissection (AD) is a critical condition, particularly in the elderly.
- Limited research exists on long-term surgical outcomes for octogenarians with Type A aortic dissection (TAAD).
Purpose of the Study:
- To evaluate long-term surgical outcomes of TAAD in octogenarians.
- To compare outcomes between surgical and medical management in octogenarians.
- To compare octogenarian outcomes with those of septuagenarians.
Main Methods:
- Systematic review and meta-analysis of observational studies and RCTs.
- Searched four electronic databases (inception–November 2022).
- Used Mantel-Haenszel method to pool estimates and calculate odds ratios (OR) with 95% confidence intervals (CI).
Main Results:
- Surgical repair in octogenarians demonstrated lower rates of re-exploration (9%), stroke (10%), and respiratory failure (19%) versus medical treatment.
- Octogenarians had shorter cardiopulmonary bypass (161.89 min), cross-clamp (103.18 min), and myocardial ischemic times (90.89 min).
- Compared to septuagenarians, octogenarians had shorter cardiopulmonary bypass and cardiac arrest times but a higher risk of respiratory complications (RR=1.60).
Conclusions:
- Surgical repair is associated with improved outcomes for octogenarians with TAAD compared to medical management.
- Octogenarians experience distinct surgical challenges, including a higher incidence of respiratory complications.
- Findings highlight the need for tailored surgical approaches in this fragile elderly population.
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